John Ellis (Fianna Fail)

Like other Members, I congratulate the Leas-Chathaoirleach on his appointment. I welcome the Minister, Deputy Harney, to this House where we both started in the Oireachtas together on the same day. We will not say how long ago.

In some ways the Bill is probably going much further than people might expect, but in other ways it does not go far enough. A number of anomalies arise when one considers the dominant position of the VHI in the private health insurance market. As other Senators have outlined, when patients go to hospital for certain procedures, they discover they are not covered by the VHI, irrespective of which policy they hold, while other minor procedures are covered. This matter must be examined.

Preventative medicine is perhaps of more importance where health insurers are concerned. There is a need for all health insurers to outline in detail to prospective policyholders what is covered. In some cases one is covered for certain procedures, but in other cases one does not get the cover to which one feels entitled and one ends up paying.

The VHI and other health insurers could perhaps examine the provision of care for the elderly. In recent times it has fallen to the State to carry this burden. The Minister has made some progress in this regard but her efforts are being thwarted by the Health Service Executive in certain categories of provision. A number of community projects exist throughout the country for which funding has been provided by the Departments of Health and Children and Finance, but the Health Service Executive has not proceeded to carry out the necessary work. I will outline the detail of these projects to the Minister in writing. It is wrong that although we are providing the money, people are not getting the service they require either on a public or private basis. Something must be done.

As far as I can gather, the HSE is at loggerheads with everybody and is not delivering a service to the public. We know change is required and even though it affects my part of the country, I welcome the measures announced yesterday by the Minister to provide centres of excellence for cancer treatment. The change is in the best interests of patients. If somebody wants to go to Dublin for a day's shopping, he or she will get there so I do not see how in most cases he or she cannot also get to Dublin to access health care. In providing centres of excellence, the HSE is probably doing more for the long-term benefit of patients than certain individuals want to accept.

There is a need for VIVAS Health, Quinn Healthcare and the VHI to explain to their customers exactly what is covered by their premia. It is obvious the health care market is a lucrative one when one considers some of the tactics employed to stimulate business. One company is offering free home insurance to customers who already have health insurance and car insurance with it. That proves to me the market is overcharging. If it were not overcharging, the margins would not exist to allow insurers to offer such carrots to customers. There is a need to review current charges.

While we are trying to ensure the VHI remains solvent and obeys the regulations, we must send out a clear message from this House that private health insurance must be fully reviewed. I agree with the point made by Senator Twomey and other speakers. Perhaps it is time for a debate in this House on private health insurance and the operation of the HSE. Everything comes back to the Minister. In many cases he or she has provided the funds but the people who are responsible for delivering the service are not doing what they should.